Aphasie und Geisteskrankheit1)

[Carl Wernicke (1848-1905) and the "Wernicke-Kleist-Leonhard school". Connections to "Erlangen School" of psychiatry]

BACKGROUND

To celebrate Carl Wernicke's 170th anniversary, the paper aims at analysing possible connections of Wernicke and his "Wernicke-Kleist-Leonhard (WKL) school" to the "Erlangen school" of psychiatry.

METHODS

Relevant primary and secondary literature as well as archival material were examined to test the hypothesis.

RESULTS

Wernicke's efforts to realise his nosological system in clinical practice were continued by his pupil Karl Kleist (1879-1960). After Wernicke's tragic early death Kleist worked under Gustav Specht's "Erlangen school of psychiatry". Karl Leonhard (1904-1988), who worked under Specht as well as under Kleist, continued Wernicke's and Kleist's research and ended up with a very differentiated classification of endogenous psychoses.

DISCUSSION

Specht's "Erlangen school" of psychiatry can be regarded as a link in the development of the "Wernicke-Kleist-Leonhard school". Wernicke's description of "anxiety psychosis" motivated Specht to study the emotion of anxiety in "manic-depressive disorder". Specht's study again stimulated Leonhard's concept of "anxiety-happiness psychosis". Generally, Specht's intensive focus on bipolarity has influenced Leonhard's concept of cycloid psychoses. Specht's description of "pathologic affect" had an impact on Leonhard's concept of "affect-laden paraphrenia".

CONCLUSION

Modern methods of neuro-imaging open a new perspective to Wernicke's localisation theory. The natural-scientific-philosophical "double orientation" of the WKL school motivates an increased integration of philosophical elements (ethics, religiosity, spirituality) in the field of psychiatry, psychosomatic medicine and psychotherapy.